血清Irisin、PTX3及MALAT1水平与糖尿病视网膜病变病情程度的关系及联合诊断价值  

Correlation between serum Irisin,pentraxin 3,metastasis-associated lung adenocarcinoma transcript 1 levels and the severity of diabetic retinopathy and the value of combined diagnosis

作　　者：李博 刘明远[2] 李幸 张新桥 曹婷婷[1] 王曦 李朝霞[1] 柏玲 LI Bo;LIU Mingyuan;LI Xing;ZHANG Xinqiao;CAO Tingting;WANG Xi;LI Zhaoxia;BAI Ling(Ophthalmology Department 1 of Cangzhou Central Hospital,Cangzhou 061017,Hebei Province,China;Anesthesia Department 1 of Cangzhou Central Hospital,Cangzhou 061017,Hebei Province,China;Respiratory and Critical Care Medicine Department 2,Cangzhou Central Hospital,Cangzhou 061017,Hebei Province,China;Ophthalmology Department of the First Affiliated Hospital of South China University,Hengyang 421009,Hunan Province,China)

机构地区：[1]沧州市中心医院眼一科,河北省沧州市061017 [2]沧州市中心医院麻醉一科,河北省沧州市061017 [3]沧州市中心医院呼吸与危重症医学二科,河北省沧州市061017 [4]南华大学附属第一医院眼科,湖南省衡阳市421009

出　　处：《眼科新进展》2024年第6期470-475,共6页Recent Advances in Ophthalmology

基　　金：沧州市重点研发计划指导项目(编号:222106098)。

摘　　要：目的研究血清鸢尾素(Irisin)、长正五聚蛋白3(PTX3)、人肺腺癌转移相关转录本1(MALAT1)水平与糖尿病视网膜病变(DR)病情程度的关系及联合诊断的价值。方法选取2022年4月至2023年4月沧州市中心医院2型糖尿病(T2DM)合并DR患者85例设为DR组,85例单纯T2DM患者设为非DR组,同时期85例健康志愿者设为对照组。将DR组患者以是否处于增生型DR为标准分为增生型组(38例)与非增生型组(47例)。收集DR组患者病例临床资料,包括性别、舒张压、年龄、收缩压、病程、空腹血糖(FPG)、体质量指数、糖化血红蛋白(HbA1c)、吸烟史、甘油三酯(TG)、饮酒史、收缩期峰值流速、舒张末期峰值流速、阻力指数、空腹胰岛素(FINS)、糖尿病家族史、总胆固醇(TC)、胰岛素抵抗指数(HOMA-IR)。酶联免疫吸附法检测各组患者血清Irisin、PTX3水平,实时荧光定量PCR法检测血清MALAT1水平。采用Pearson相关性分析检测血清Irisin、PTX3及MALAT1水平与DR患者病情程度的相关性。Logistic回归分析DR患者病情程度的影响因素。受者工作特征曲线(ROC曲线)分析血清Irisin、PTX3及MALAT1单独诊断DR的价值。ROC曲线、净重新分类指数(NRI)及综合判别改善指数(IDI)分析含与不含血清Irisin、PTX3及MALAT1方案诊断DR的价值。结果3组患者血清Irisin、PTX3、MALAT1水平比较,差异均有统计学意义(均为P<0.001)。增生型组患者病程长于非增生型组,收缩期峰值流速、舒张末期峰值流速、血清Irisin水平均低于非增生型组,阻力指数、FPG、HbA1c、TG、FINS、HOMA-IR及血清PTX3、MALAT1水平均高于非增生型组,差异均有统计学意义(均为P<0.05)。DR患者血清Irisin水平与DR病情程度呈负相关(r=-0.512,P<0.001),PTX3、MALAT1水平与DR病情程度均呈正相关(r=0.497、0.573,均为P<0.05)。Logistic回归分析结果显示,病程、FPG、HbA1c、TG、FINS、HOMA-IR、收缩期峰值流速、舒张末期峰值流速、阻力Objective To investigate the correlation between serum Irisin,long pentraxin 3(PTX3),human metastasis-associated lung adenocarcinoma transcript 1(MALAT1)levels and the severity of diabetic retinopathy(DR)and the value of combined diagnosis.Methods Eighty-five patients with type 2 diabetes mellitus(T2DM)combined with DR at Cangzhou Central Hospital from April 2022 to April 2023 were selected as the DR group,85 patients with T2DM alone were selected as the non-DR group,and 85 healthy volunteers were selected as the control group during the same period.Patients in the DR group were further divided into the proliferative DR(PDR)group(38 patients)and the non-PDR group(47 patients)based on whether DR was in the proliferative phase.Clinical data of patients in the DR group were collected,including gender,diastolic pressure,age,systolic pressure,disease course,fasting plasma glucose(FPG),body mass index,hemoglobin A1c(HbA1c),smoking history,triglyceride(TG),drinking history,peak systolic velocity(PSV),peak end-diastolic velocity(PEDV),resistance index(RI),fasting insulin(FINS),family history of diabetes,total cholesterol(TC),and homa-insulin resistance(HOMA-IR).Enzyme-linked immunosorbent assay was used to detect serum levels of Irisin and PTX3 in each group of patients,and real-time quantitative polymerase chain reaction was used to detect the serum level of MALAT1.The correlations between serum levels of Irisin,PTX3 and MALAT1 and the severity of DR were analyzed using the Pearson correlation coefficient.The influencing factors of the DR severity were identified using the Logistic regression.The value of serum Irisin,PTX3,and MALAT1 levels in diagnosing DR alone was analyzed using the receiver operating characteristic(ROC)curve.The value of regimens containing and not containing serum Irisin,PTX3,and MALAT1 levels in diagnosing DR was analyzed using the ROC curve,net reclassification index(NRI),and integrated discrimination improvement(IDI)index.Results The serum levels of Irisin,PTX3,and MALAT1 were compared among the

关 键 词：Irisin PTX3 MALAT1 糖尿病视网膜病变 病情程度 诊断价值 

分 类 号：R774[医药卫生—眼科]